Objective:This meta-analysis aims to explore the most consistent changes in cortical thickness in drug-naive first-episode patients with major depressive disorder (DF-MDD).Methods:Systematic and comprehensive searches were conducted to acquire relevant literature from the PubMed and Web of Science databases for the studies published from inception to July 23, 2023, by using the keywords ("depression" OR "depressive disorder" OR "unipolar depression") AND ("cortical thickness"OR"thickness"). The SDM (signed differential mapping) software was used to perform whole-brain voxel-wise meta-analysis, heterogeneity test, and assess publication bias. Meta-regression analysis was employed to examine the impact of disease severity on cortical thickness in depression, and heterogeneity was tested, along with an assessment of publication bias.Results:Eight studies were ultimately included, encompassing 417 DF-MDD patients and 409 healthy controls. Compared to the healthy control group, DF-MDD patients exhibited significantly decreased cortical thickness in multiple brain regions, including the supplementary motor area ( Z=-2.471, P<0.000 5) and the rolandic operculum ( Z=-2.190, P<0.000 5). Further regression analysis found that the disease severity was positively correlated with the cortical thickness in the supplementary motor area ( Z=2.265, P<0.000 5) and the rolandic operculum ( Z=1.56, P<0.000 5). Additionally, the average depressive duration was positively correlated with cortical thickness in the right opercular part of the inferior frontal gyrus ( Z=1.922, P<0.000 5), and negatively correlated with changes in the right midcingulate cortex ( Z=-3.035, P<0.000 5) in DF-MDD. Conclusion:DF-MDD patients exhibit reduced cortical thickness in the supplementary motor area and the operculum area during the early stages of the disease. And the observed pattern of cortical alterations is associated with both the severity and duration of the disease.

Objective:This meta-analysis aims to explore the most consistent changes in cortical thickness in drug-naive first-episode patients with major depressive disorder (DF-MDD).Methods:Systematic and comprehensive searches were conducted to acquire relevant literature from the PubMed and Web of Science databases for the studies published from inception to July 23, 2023, by using the keywords ("depression" OR "depressive disorder" OR "unipolar depression") AND ("cortical thickness"OR"thickness"). The SDM (signed differential mapping) software was used to perform whole-brain voxel-wise meta-analysis, heterogeneity test, and assess publication bias. Meta-regression analysis was employed to examine the impact of disease severity on cortical thickness in depression, and heterogeneity was tested, along with an assessment of publication bias.Results:Eight studies were ultimately included, encompassing 417 DF-MDD patients and 409 healthy controls. Compared to the healthy control group, DF-MDD patients exhibited significantly decreased cortical thickness in multiple brain regions, including the supplementary motor area ( Z=-2.471, P<0.000 5) and the rolandic operculum ( Z=-2.190, P<0.000 5). Further regression analysis found that the disease severity was positively correlated with the cortical thickness in the supplementary motor area ( Z=2.265, P<0.000 5) and the rolandic operculum ( Z=1.56, P<0.000 5). Additionally, the average depressive duration was positively correlated with cortical thickness in the right opercular part of the inferior frontal gyrus ( Z=1.922, P<0.000 5), and negatively correlated with changes in the right midcingulate cortex ( Z=-3.035, P<0.000 5) in DF-MDD. Conclusion:DF-MDD patients exhibit reduced cortical thickness in the supplementary motor area and the operculum area during the early stages of the disease. And the observed pattern of cortical alterations is associated with both the severity and duration of the disease.

Objective:To study the risk factors and clinical outcomes of early pulmonary hypertension in preterm infants with gestational age(GA)≤32 w.Methods:From October 2017 to May 2021,preterm infants with GA≤ 32 w admitted to NICU of our hospital were retrospectively studied. According to their echocardiography 2 w after birth, the infants were assigned into early-onset pulmonary hypertension (ePH) group and non-PH group. SPSS 21.0 statistical software was used to analyze the general status, complications and clinical outcomes of the two groups. Multiple logistic regression was used to analyze the risk factors of early-onset PH.Results:A total of 183 cases were enrolled, including 24 in the ePH group and 159 in the non-PH group. The incidences of birth asphyxia, hemodynamically significant patent ductus arteriosus (hsPDA), FiO 2≥30% within 6 h after birth, late-onset PH, severe bronchopulmonary dysplasia(BPD) and intracranial hemorrhage(ICH) in the ePH group were significantly higher than the non-PH group( P<0.05). hsPDA was the independent risk factor for early-onset PH ( OR=11.781, 95% CI 4.192-33.108). Conclusions:Preterm infants with GA≤32 w and early-onset PH are at increased risks of ICH, late-onset PH and severe BPD, hsPDA is the independent risk factor for early-onset PH.

Objective:To study the characteristics and clinical diagnostic value of multiparametric magnetic resonance imaging (mp-MRI) for prostate cancer (PCa).Methods:The clinical data of patients with PCa and benign prostatic hyperplasia (BPH) treated in Qinhuangdao Second Hospital from January 2019 to December 2019 were retrospectively analyzed. They were divided into PCa group and BPH group. T2-weighted imaging (T2WI), diffusion weighted imaging (DWI) and dynamic contrast enhanced (DCE)-MRI were performed respectively. The T2WI image characteristics, peripheral band and transitional band apparent diffusion coefficient (ADC) values and DCE-MRI image types were compared between the two groups. Patients in the two groups were evaluated by Prostate Imaging Reporting and Data System (PI-RADS) v2 Score. Receiver operating characteristic (ROC) curve was used to analyze the value of mp-MRI sequences in the differential diagnosis of PCA and BPH.Results:There were significant differences in image features of T2WI and DWI between PCa group and BPH group; the ADC values of both patients in peripheral zone were significantly higher than those in transition zone (all P<0.05); the ADC values of PCa patients in peripheral zone and transition zone were significantly lower than those of BPH patients (all P<0.05). There were statistically significant differences in the types of DCE-MRI images in PCa and BPH patients ( P<0.05), and the Tmax of PCa patients was significantly lower than that of BPH patients ( P<0.05), while the SImax was significantly higher than that of BPH patients ( P<0.05). PI-RADS v2 Score showed that there were statistically significant differences in the T2WI and DWI scores between PCa patients and BPH patients ( P<0.05), and the positive rates of DCE-MRI in the two groups were 94.00% and 24.00% respectively ( P<0.05). ROC curve analysis showed that the sensitivity of T2WI, DWI, DCE-MRI and combined diagnosis of PCa and BPH were 64.0%, 76.0%, 94.0% and 96.0% respectively, and the specificity were 90.0%, 92.0%, 76.0% and 84.0%. Conclusions:mp-MRI sequences have many differences in PCa and BPH. Combined with RI-RADS v2, it can effectively identify and is of great significance for improving the early diagnosis of PCa.

Objective:To investigate the efficacy differences between domestic gefitinib and original gefitinib in the first-line treatment of patients with epidermal growth factor receptor (EGFR) sensitive mutation advanced non-small cell lung cancer (NSCLC) (stage Ⅲ B and Ⅳ). Methods:A total of 91 cases with EGFR sensitive mutation advanced NSCLC in Dezhou People's Hospital of Shandong Province from January 2017 to July 2019 were selected and were randomly divided into the observation group (47 cases) and the control group (44 cases) according to random number table method. The observation group was given the treatment of domestic gefitinib, and the control group was given the treatment of original gefitinib, and then the treatment outcome, adverse reactions, survival status and the cost of two groups were compared.Results:The objective response rate in the observation group and the control group was 91.5% (43/47) and 84.1% (37/44), respectively; the disease control rate in the observation group and the control group was 100.0% (47/47) and 97.7% (43/44), respectively; and the differences were not statistically significant ( χ2 = 2.708, P = 0.224; χ2 = 1.080, P = 0.484). The median progression-free survival (PFS) time of domestic gefitinib group and original gefitinib group was 13.26 months (95% CI 11.34-14.66 months) and 13.19 months (95% CI 12.52-15.48 months), respectively, and the difference was not statistically significant ( P = 0.735). The subgroup analysis showed that the median PFS time of patients with an exon 19 deletion mutation in the observation group and the control group was 12.98 months (95% CI 11.25-14.75 months) and 13.89 months (95% CI 12.04-15.96 months), respectively, and the difference was not statistically significant ( P = 0.604). The median PFS time of patients with an exon 21 L858R missense mutation in the observation group and the control group was 15.08 months (95% CI 11.79-18.21 months) and 11.94 months (95% CI 9.20-14.79 months), and the difference was not statistically significant ( P = 0.114). There was no statistically difference in the incidence of adverse reactions including skin rash, diarrhea, interstitial pneumonia, oral mucositis, nausea and vomiting, myelosuppression, abnormal aminotransferase of the two groups of patients (all P > 0.05). The treatment cost in the observation group and the control group during the treatment period was (2 118.43±137.93) yuan per month and (5 945.48±247.48) yuan per month, respectively, and the difference was statistically significant ( t = 12.854, P = 0.001). Conclusions:Domestic gefitinib and original gefitinib have the same therapeutic efficacy in the treatment of EGFR sensitive mutation advanced NSCLC. The adverse reactions are similar between domestic gefitinib and original gefitinib. Compared with the original gefitinib, the drug economy of domestic gefitinib is better and it can significantly reduce the financial burden of patients, and it can be used as an important option in the first-line treatment of patients with EGFR sensitive mutation advanced NSCLC.

Objective To evaluate the efficacy and safety of posaconazole for preventing invasive fungal disease (IFD) in the aplastic anemia patients receiving allogeneic hematopoietic stem cell transplantation (HSCT). Methods A total of 46 aplastic anemia patients received allogeneic HSCT. They were treated with oral posaconazole 200 mg, three times a day from HSCT pretreatment to granulocyte recovery after transplantation. G test and GM test were done 1, 2 and 4 weeks after the end of posaconazole treatment, and chest CT scan repeated 4 weeks after the end of posaconazole treatment. Posaconazole prophylaxis was defined as successful if there were no clinical manifestations indicative of fungal infection. Results All the 46 patients experienced neutropenia. The median of absolute neutrophil count (ANC) nadir was 0.02 (0-0.05)×109/L for a median time of 10 (8-19) days. The median duration of posaconazole prophylaxis was 26 (15-41) days. Neutropenic fever was reported in 45 patients, which lasted a median time of 5 (1-13) days. Six patients (13.3％ of the patients with neutropenic fever) failed to respond to the empirical treatment of broad spectrum antibiotics with persistent fever over 7 days. Their treatment was switched to short-term empirical treatment with broad spectrum antifungal agents. However, subsequent G test, GM test and chest CT showed negative results. None of the six patient was consistent with IFD diagnosis. Breakthrough fungal infection was not considered. Oral posaconazole solution was resumed for preventing IFD. G test, GM test and chest CT scan did not show any sign of fungal infection 1, 2 and 4 weeks after the end of posaconazole prophylactic treatment in all the 46 patients, proving the success of oral posaconazole in preventing IFD. Posaconazole was not discontinued due to adverse drug reaction in any patient. Conclusions Posaconazole is effective for preventing IFD in the aplastic anemia patients receiving HSCT with good safety profile and few adverse reactions.

Objective:To explore the association between rheumatoid arthritis(RA)and two polymorphisms of interleukin-17(IL-17F)rs763780 and rs2397084.Methods: A systematic search of relevant studies was conducted in China National Knowledge Infrastructure,Wanfang Chinese Periodical Database,China Biology Medical Literature Database,Pubmed,Embase and Web of Science.Results: A total of 5 case-control studies including 1 174 RA cases and 966 health controls for rs763780 and 985 RA cases and 766 health controls for rs2397084 were included in this Meta-analysis.The results showed that rs763780 was significantly associated with increased susceptibility to RA(C vs.T:OR=1.74,95%CI=1.01-2.98,P=0.04;CC vs.TT:OR=3.17,95%CI=1.21-8.35,P=0.02;CT vs.TT:OR=1.80,95%CI=1.21-2.66,P=0.004;CC+CT vs.TT:OR=1.96,95%CI=1.35-2.83,P<0.001;CC vs.CT+ TT:OR=2.97,95%CI=1.13-2.66,P=0.03).In subgroup analysis based on ethnicity,rs763780 was positively correlated with RA in Europeans.No significant association was found between rs2397084 and RA.Conclusion: The present study revealed that IL-17F rs763780 polymorphism is a risk factor of RA,while the association of rs2397084 with RA remains uncertain.

Objective To select and train researchers in the multi-center study of pressure sores, and to ensure the quality of this research center.Methods We Recruited 112 in-service nurses in the hospital, then 87 nurses were selected as the researchers of pressure sores. 87 nurses received pressure score training for 20 hours, and these training included identifying the stage and extent of damage of pressure sores through pictures, multimedia teaching, analysis of difficult case, field teaching rounds, pressure sores knowledge contests and other means. Three days after training, unified test paper and assessment were used to get know the effect of training, and for the unqualified personnel, the same method would be used to training and test. Results The average written test score of 87 nurses who participated in personnel training of pressure sores before training was (47.70±15.08)(the first score) points, and was (84.46±11.35)(the second score) points after training. Only 44 nurses were qualified after training, and 43 were unqualified and they received the second training. After the second training, 24 nurses were qualified, and the average score was (87.86±7.23)(the third score) . The difference between the first score and the second score was statistically significant ( t=-16.710,P<0.01), and the difference between the first and third score was statistically significant (t=-12.742,P<0.01), and the difference between the second and third score was not statistically significant (t=-1.403,P>0.05). Conclusions Repeatedly training increases the number of qualified nurses, and improves their ability to identify pressure sores and skin lesions. Finally 68 qualified researchers of pressure sores are selected. Thus, specification system of training can be the method to improve the level of research pressure sores.